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General NPI Number Information
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NPI Number | 1154958429
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Entity Type | Individual
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Provider Name | MARK CHAPMAN WOODS OTR
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Gender | Male
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 03/25/2020
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Provider Practice Location Address
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Address Line | 2811 NE 139TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-2724
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Country | US
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Telephone | 360-574-5247
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Fax |
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Provider Business Mailing Address
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Address Line | 509 N 40TH AVE
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City | RIDGEFIELD
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State | WA
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Zip | 98642-8271
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Country | US
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Telephone | 360-721-0549
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 60336467
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License Number State | WA
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